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Objective To analyze the expression of immune cells and immunosuppressive factors in the immune microenvironment of glioblastoma. Methods A total of 30 glioma specimens, all of which were glioblastoma (IDH⁃wildtype), were surgically removed and completely preserved in the First Affiliated Hospital of Ji'nan University and Guangdong Sanjiu Brain Hospital from November 2020 to April 2021. T lymphocytes (CD3+ T cells, CD4+ T cells, CD8+ T cells), suppressive immune cells [FoxP3+ regulatory T cell (Treg)], immunosuppressive factors [transforming growth factor⁃β (TGF⁃β)], immunosuppressive factors [programmed cell death protein ligand 1 (PDL1)] in the immune microenvironment of glioblastoma were detected by immunohistochemistry. Results The proportion of CD4+ T cells in glioblastoma was very low. CD3+ T cells accounted for more than 3% in 15 cases (50%), and CD8+ T cells were similar to CD3+ T cells. Few FoxP3+ Treg cells were detected in only 2 cases (6.67%). The cytoplasm of 24 cases (80%) of glioblastoma showed strong positive expression of TGF⁃β, and its expression was correlated with the distribution of CD3+ T cells. No CD3+ T cells were found in the areas with high expression of TGF⁃β, and CD3+ T cells were widely distributed in the areas with low expression of TGF⁃β. PDL1 expression was non⁃detected. Conclusions TGF⁃β protein was highly expressed in glioblastoma, and future drugs or immunotherapies designed to target TGF⁃β may contribute to the clinical treatment of glioblastoma.

DOI: 10.3969/j.issn.1672-6731.2018.02.012

A 19-year-old female was admitted to our department, complaining of shadow in front of the left eye for 8 months, headache for one month, blurred vision and tinnitus for 2 weeks. Bilateral papilledema was the presumed diagnosis. Neurological examination revealed modest left abducens nerve palsy, diplopia, nystagmus and a stiff neck. Lumbar puncture demonstrated marked intracranial hypertension (>330 mmH2O, normal range 70-180 mmH2O), modestly elevated protein (0.61 g/L, normal range 0.15-0.45 g/L), low concentration of glucose (1.90 mmol/L, normal range 2.80-4.50 mmol/L) and moderate pleocytosis (116/uL, normal range 0-8/uL). CSF cytology suggested lymphocyte-dominant inflammation with elevated ratio of eosinophils (5%, normal range 1-2%). Cranial MRI demonstrated a subarachnoid cystic lesion located at the right temporal lobe, 2 round-like cystic lesions located at the prepontine region. The positive antibodies to T. solium in serum and CSF further confirmed the diagnosis of neurocysticercosis. The patient received oral administration of antiparasitic drug (albendazole 0.40 g twice a day), intravenous infusion of mannitol (125 ml 2-4 times a day) and steroids (dexamethasone 5 mg twice a day) for 3 weeks. The patient experienced a febrile headache as the dose of steroids was reduced, but was rapidly resolved after resuming the steroids as well as intravenous antibiotics (ceftriaxone sodium, 1 g twice a day). After treatment, repeated cranial MRI demonstrated that the subarachnoid cystic lesion located at the right temporal lobe was modestly resolved, while lesions located at the prepontine region remained almost unchanged. The patient was then discharged, and was told to repeat the regimen 2-3 times at an interval of one month. DOI: 10.3969/j.issn.1672-6731.2015.06.016

doi: 10.3969/j.issn.1672-6731.2014.12.019

Background and objective 50%-70% of patients with advanced lung cancer will develop bone metastases. The aim of this study is to establish the nude mice bone metastasis model of lung adenocarcinoma using A549, H1299, SPC-A-1 and XL-2, all of which own different invasion and migration abilities in vitro and supervise the bone metastases by MicroCT. Methods fifty BALB/C-nu/nu nude mice were grouped into five groups on average randomly. Cells of the four cell lines were injected into the left cardiac ventricle of mice in the four experimental groups (0.2 mL/mouse) respectively; meanwhile, mice in the control group were injected with normal saline (0.2 mL/mouse) in the same manner. Periodical radiological examination was carried out to supervise the variation of the mice since the second week after injection. When mice in each group became thin obviously, end the experiment of this group. Before the end, pathological sections of bone tissues were made. We classified the bone metastatic sites into axial skeleton and limb bone, in order to compare the metastatic rates of these two different parts. The bone metastatic abilities of the four cell lines was statistically analyzed by comparing the average time cost in the appearance of bone metastases and the percentage of bone metastases among the experimental groups. Results Different metastatic sites which had been identified both by MicroCT and pathological sections appeared in each group of the four experimental groups. By contrast, no metastasis was observed in the control group. The percentage of cancer metastasizing to axial skeleton was remarkably higher than the percentage of tumor metastasizing to the limb bone in each experimental group, which was consistent with the clinical regularity and characteristics of skeletal metastases with lung cancer. Thus, the model has been established triumphantly. However, there were no statistical differences in the average time consumed and skeletal metastatic rate among the four experimental groups. Conclusion The disruption in the bone can be clearly detected by MicroCT, which is benefit to supervise the osseous metastasis. We successfully developed the nude mice bone metastasis model of lung adenocarcinoma, which will pave the way for exploring novel prevention and therapy strategies clinically. The four cell lines varied in invasion and migration abilities in vitro, but there was no statistical difference in the metastatic ability in vivo, and the reason need to be explored further in future.

Objective To analyze the expression of immune cells and immunosuppressive factors in the immune microenvironment of glioblastoma. Methods A total of 30 glioma specimens, all of which were glioblastoma (IDH - wildtype), were surgically removed and completely preserved in the First Affiliated Hospital of Ji'nan University and Guangdong Sanjiu Brain Hospital from November 2020 to April 2021. T lymphocytes (CD3+ T cells, CD4+ T cells, CD8+ T cells), suppressive immune cells [FoxP3+ regulatory T cell (Treg)], immunosuppressive factors [transforming growth factor - β (TGF - β)], immunosuppressive factors [programmed cell death protein ligand 1 (PDL1)] in the immune microenvironment of glioblastoma were detected by immunohistochemistry. Results The proportion of CD4+ T cells in glioblastoma was very low. CD3+ T cells accounted for more than 3% in 15 cases (50%), and CD8+ T cells were similar to CD3+ T cells. Few FoxP3+ Treg cells were detected in only 2 cases (6.67%). The cytoplasm of 24 cases (80%) of glioblastoma showed strong positive expression of TGF - β, and its expression was correlated with the distribution of CD3+ T cells. No CD3+ T cells were found in the areas with high expression of TGF-β, and CD3+ T cells were widely distributed in the areas with low expression of TGF-β. PDL1 expression was non- detected. Conclusions TGF - β protein was highly expressed in glioblastoma, and future drugs or immunotherapies designed to target TGF-β may contribute to the clinical treatment of glioblastoma. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of IL-2+IL-15 costimulated CIK adoptive immunotherapy combined with chemotherapy for colorectal cancer. Methods 110 colorectal cancer patients were selected from the department of general surgery in Yan'an Hospital. 55 cases were treated with CIK combined with chemotherapy, and the other 55 cases were treated with simple chemotherapy. The immune function, efficacy, toxicity and quality of life after treatment in each group were evaluated. Results The stronger cytotoxicity and rapid proliferation efficiency were found in IL-12+IL-15 stimulated CIK cells than simple IL-2 stimulated CIK cells. T cell subsets in peripheral blood increased in CIK combined with chemotherapy group before and after treatment, but there were no significant changes (P> 0.05). The ratios of CD3+, CD4+, CD8+, CD16+ CD56+, NKp46, NKG2D, CD lib, CD27 cells in peripheral blood decreased after treatment in chemotherapy group. The kamofsky score was 87.3% and 69.3% in combined immune therapy group and simple chemotherapy group, respectively, and there was a significant difference between two groups (P<0.05). Conclusion IL-2+IL-15 costimulated CIK adoptive immunotherapy combined with chemical therapy can significantly improve the immune function of patients with colorectal cancer, improve the overall efficacy, reduce the adverse reactions of chemotherapy, prolong progression-free survival, and improve patients' quality of life. [ABSTRACT FROM AUTHOR]

A research was performed on the jacket structure located in the new oil storage port which can accommodate 300 and 450 thousand DWT crude oil ships in Dalian. Compared with gravity type caisson, mechanical behaviors and construction characteristics of jacket structure type are presented. Design work and method of jacket structure applied to open style offshore deep-water wharf are discussed, such as member's strength, member's stability, socketed length and bearing capacity of rock-socketed pile, static strength and fatigue life of tubular joints. This structure, which can be used in open style wharf when depth of water is more than 25 m, is calculated and optimized. It is shown that this structure is more economical than the gravity circular caisson jacket structure, and can meet the standards of design work. The employment of jacket structure in open style offshore deep-water wharf is safe, feasible and economical in China. Achievements from the study can guide the design of open style wharf. [ABSTRACT FROM AUTHOR]

The article examines the expression and activity of Staphylococcus aureus enterotoxin A (SEA) in Bacillus subtilis in Jilin, China. Researchers used electrotransformation to transform recombinant plasmid pBC38c-SEA into Bacillus subtilis 1A751 (BS) and concentrated supernatant protein by ammonium sulfate and bacterial precipitation. They found that expression plasmid pBC38c-SEA is constructed and expressed successfully in BS.

The article reports on the veterinary study of Xu Yi-ming and colleagues which aimed to identify H5, H7, and H9 subtypes of avian influenza viruses (AIV) through AC-ELISA assay. It states that the double antibody assay was performed and optimized to detect the nucleic acid of AIV. It indicates that the optimized mass concentration of monoclonal antibody has a high specificity and sensitivity to certain temperatures.

PURPOSE: To evaluate the possibility of repairing anterior palatal fistula using abundant self dermic graft with subdermal vascular rete. METHODS: Twenty-one patients with anterior palatal fistula one year after cleft palate repair were selected. The diameters of the fistula 0.5cmx0.6cm to 1.0cmx1.5cm. The peripheral tissue flap was prepared and sutured as nasal layer, and the exposed wound surface was covered by free graft with subdermal vascular plexus, while the exposed surface to the oral cavity was protected with tela iodoformiata. RESULTS: Except for 3 patients in whom the iodoform gauze fell off which led to dissolution of exposed dermis, the remaining patients had an excellent restoration of the fistula, with a recurrent rate of 14.2%. CONCLUSSION: The use of dermic tissue with subdermal vascular rate is reliable to repair anterior palatal fistula. [ABSTRACT FROM AUTHOR]

The Appraisal System proposed by Martin and White is an extension of Hallidayan Systemic Functional Linguistics. It is a functional model of interpersonal meaning al the level of discourse semantics, aimed to explore, describe and explain the way language is used to evaluate, to adopt stances, to construct textual personas and to manage interpersonal relationships. The theory is concerned with the linguistic resources by which texts/speakers come to express, negotiate and naturalize particular inter-subjective and ultimately ideological positions. Within this broad scope, the theory focuses particularly on the language of evaluation, attitude and emotion. In the Appraisal System, evaluative resources are divided into three semantic domains, i.e. attitude, engagement and graduation. The engagement system is one of the options for expanding or contracting space for other voices in discourse, enabling an investigation of the dynamic management of other voices by the speaker/writer. In the engagement system, resources are dealt with for positioning the speaker' s/author' s voice with respect to the various propositions and proposals conveyed by a text. Engagement markers, a metadisocurse in nature, play an important role to achieve this purpose. In the past, studies of discourse markers have mainly focused on the marker's role of coherence in the text. Few attempts have been made to explore the semantics of evaluation these markers exhibit. On the other hand, the Appraisal System has so far analyzed the language of appraisal mainly from the perspective of lexis. The present study, starting from the engagement system, is an attempt to examine the interpersonal functions of engagement markers in the genre of TV interviews. Within the engagement system framework, the engagement markers are divided into two groups: intra-vocalization group and extra-vocalization group. These markers are analyzed and discussed front the perspective of inter-subjective positioning with reference to context and Bakhtin's idea of dialogism and heteroglossia. The data are three interviews from the CCTV on the same topic and six people from different backgrounds joined in the talk. The analysis indicates that the TV host adopts different discourse strategies by making use of different engagement markers when interviewing people from different social backgrounds and when taking into account the target TV interviews. This represents an active communicative attitude. The interpersonal meaning realized by engagement markers is generated in interaction and constrained by context. Engagement markers play an important role in facilitating interaction between the TV host, interviewees and the TV audience at large and in making the interviews a success. Appraisal is a way to realize the interpersonal meaning of discourse. The concern in this study is with the meanings that are realized dynamically through a series of engagement markers in TV interviews. The research design is qualitative and interpretive in approach, aimed at an in-depth analysis of the engagement markers in three TV interviews. This approach complies with Martin's view of discourse analysis: what is unique about a specific text may be just what matters. [ABSTRACT FROM AUTHOR]

Small reservoirs in the Yangtze River are large in quantity and widely distributed, which have important ecological and economic benefits. It is of great significance to explore the response law of small reservoir water quality to environmental variables for improving reservoir water quality. Based on the measured water quality data of 36 small reservoirs in the upper reaches of the Yangtze River, combined with the measured water quality data, using correlation analysis, redundancy analysis, and other research methods, we divided the environmental variables into three categories:landscape configuration index, landscape composition index, and reservoir characteristic index, and explored their impact on the change in water quality index. The research results showed that:① farms were the main source of NO 3 - -N, TN, and TP, and residential land was the main source of TP. Paddy, forest land, and wasteland had positive effects on the retention and purification of N and P in reservoirs. ② The LPI of farms was significantly positively correlated with the concentrations of TN and NO 3 - -N in the reservoir, and the paddy and forest were significantly negatively correlated with the concentrations of NO 3 - -N and TN in the reservoir. The PD of farms was positively correlated with TP. The LPI was negatively correlated with TP content. ③ The correlation between average reservoir depth and reservoir water quality was the strongest. Reservoir capacity, reservoir average depth, and reservoir LSI had significant positive effects on water quality improvement. ④ Among the environmental variables of the reservoir, landscape configuration index had the highest explanatory rate (24%), followed by that of the reservoir characteristics index (11%) and landscape composition index (9%). Watershed factors were the key factors (55%), and internal factors (19%) also had a significant influence on reservoir water quality. The research results can provide a theoretical basis for controlling water quality degradation of small reservoirs by managing and optimizing the landscape characteristics of reservoirs.

Objective: To study the distribution of the polyphenols of Opuntia ficus-indica(L. ) Mill, and study its antioxidant and the inhibition of sugar digestive enzyme activities by vitro experiments., Methods: Using ethanol as solvent, free polyphenols, esterified polyphenols, and insoluble bonded polyphenols were extracted from the peel, pulp and seeds of Opuntia ficus-indica(L. ) Mill, and their contents were determined by the Folin-Ciocalteu method. Antioxidant activity was measured according to their ability to scavenge DPPH, OH and ABTS~(+ )radicals, and the inhibition of α-glucosidase and α-amylase activities by various types of polyphenols in various parts was observed in vitro., Results: The peel polyphenol content of Opuntia ficus-indica(L. ) Mill was(1427.15±34.48) mg GAE/100 g, the pulp polyphenol content was(525.88±51.66) mg GAE/100 g, and the seed polyphenol content was(256.92±3.81) mg GAE/100 g. The free polyphenols, esterified polyphenols, and insoluble bonded polyphenols of different parts of Opuntia ficus-indica(L. ) Mill have the ability to scavenge DPPH, OH and ABTS~(+ )radicals, and the seeds had the strongest antioxidant capacity among all parts, the esterified polyphenols and insoluble bonded polyphenols of pulp and seeds of Opuntia ficus-indica(L. ) Mill have inhibitory effects on the activities of α-glucosidase and α-amylase, with seed polyphenols have the strongest inhibitory ability., Conclusion: Opuntia ficus-indica(L. ) Mill has the highest content of polyphenols in the peel, and seed polyphenols have good antioxidant and the inhibition of sugar digestive enzyme activities.

This study was designed to assess the clinical efficacy of oral blood-activating and stasis-removing Chinese patent medicines in treating hypertensive left ventricular hypertrophy(LVH) based on network Meta-analysis. The clinical randomized controlled trials(RCTs) concerning the treatment of hypertensive LVH with oral blood-activating and stasis-removing Chinese patent medicines were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, and Cochrane Library from their inception to September 2021. Two researchers independently completed the literature screening, data extraction, and quality evaluation. The data were then analyzed by RevMan 5.3, Stata 15.1, and ADDIS 1.16.8. Finally, a total of 31 RCTs were included, involving 3 001 patients and four oral blood-activating and stasis-removing Chinese patent medicines. In terms of the alleviation of heart damage, the Chinese patent medicines combined with conventional western medicine groups were superior to the conventional western medicine groups in lo-wering the left ventricular mass index(LVMI). There was no significant difference in LVMI, left ventricular ejection fraction(LVEF), or the ratio of early diastolic peak flow velocity to late diastolic peak flow velocity(E/A) between different Chinese patent medicines combined with conventional western medicine groups. Xinnao Shutong Capsules/Tablets combined with conventional western medicine had the best efficacy in reducing LVMI and elevating LVEF, while Xinkeshu Capsules/Tablets combined with conventional western medicine had the best effect in improving E/A. In the control of blood pressure, when all Chinese patent medicines except for Xinnao Shutong Capsules/Tablets were combined with conventional western medicine, the resulting systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower than those in the conventional western medicine group. Xinkeshu Capsules/Tablets combined with conventional western medicine produced the best effect in reducing SBP and DBP, followed by Xinnao Shutong Capsules/Tablets. In terms of safety, no serious adverse reactions occurred in all trials. The four oral blood-activating and stasis-removing Chinese patent medicines included in this study exhibited obvious advantages in the treatment of hypertensive LVH when they were combined with conventional western medicine, with the best effects observed in the Xinnao Shutong Capsules/Tablets combined with conventional western medicine group. However, due to the limitation of the quantity and quality of the included articles, the conclusion of this study still needs to be verified by more high-quality, multi-center, and large-sample RCTs.

Objective: To investigate the species and activities of wild animals infected with schistosome in hilly and mountain areas by using an infrared camera technique, so as to provide the evidence for the surveillance of schistosomiasis in these areas., Methods: Six infrared cameras were selected and placed in 6 environments of the risk monitoring points of schistosomiasis in Shitai County in Anhui Province. The species and activities of the wild animals in the 6 environments were observed through the photographs and videos taken by the cameras., Results: Through 5 day's monitoring, 3 wild mammals, such as voles, hares and wild boars, were found in 4 monitoring environments, of which voles were found at 2 environments with snails, and hares, wild boars and voles were found in 2 environments adjacent to environments with snails respectively. The monitoring showed that the vole activity was most frequent in the monitored environment., Conclusions: The use of infrared camera technique has a good effect in the investigation of wild animal infectious source of schistosomiasis, and it is also suitable for the monitoring work in other types of environments.

Objective: To evaluate the effect of cementing ditch-based project on schistosomiasis control in the irrigation area of Dingshen River basin in Shitai County, Anhui Province., Methods: The data of Oncomelania hupensis snail surveys from 2009 to 2015 and the data of schistosome infections in humans and livestock from 2009 to 2015 were collected, and the changes of the epidemic situation were analyzed and compared before and after the project., Results: In the cementing ditches, the occurrence rate of living snails decreased by 68.79% and the average density of living snails decreased by 97.78%, whereas in the control areas without ditch hardening, the occurrence rate of living snails increased by 72.49% and the average density of living snails increased by 37.16%. The infection rate in humans decreased by 100%. Of 161 bovines examined with the egg-hatching method during the period, no infections were found., Conclusions: The cementing ditch-based project has a good effect on reducing the density of snails and controlling schistosomiasis.

Previous studies proposed that the synergistic effect of fibroblast growth factor-21 (FGF-21) and insulin may be due to the improvement of insulin sensitivity by FGF-21. However, there is no experimental evidence to support this. This study was designed to elucidate the mechanism of synergistic effect of FGF-21 and insulin in the regulation of glucose metabolism. The synergistic effect of FGF-21 and insulin on regulating glucose metabolism was demonstrated by investigating the glucose absorption rate by insulin resistance HepG2 cell model and the blood glucose chances in type 2 diabetic db/db mice after treatments with different concentrations of FGF-21 or/and insulin; The synergistic metabolism was revealed through detecting GLUT1 and GLUT4 transcription levels in the liver by real-time PCR method. The experimental results showed that FGF-21 and insulin have a synergistic effect on the regulation of glucose metabolism. The results of real-time PCR showed that the effective dose of FGF-21 could up-regulate the transcription level of GLUT1 in a dose-dependent manner, but had no effect on the transcription level of GLUT4. Insulin (4 u) alone could up-regulate the transcription level of GLUT4, yet had no effect on that of GLUT1. Ineffective dose 0.1 mg kg(-1) FGF-21 alone could not change the transcription level of GLUT1 or GLUT4. However, when the ineffective dose 0.1 mg x kg(-1) FGF-21 was used in combination with insulin (4 u) significantly increased the transcription levels of both GLUT1 and GLUT4, the transcription level of GLUT1 was similar to that treated with 5 time concentration of FGF-21 alone; the transcription level of GLUT4 is higher than that treated with insulin (4 u) alone. In summary, in the presence of FGF-21, insulin increases the sensitivity of FGF-21 through enhancing GLUT1 transcription. Vice versa, FGF-21 increases the sensitivity of insulin by stimulating GLUT4 transcription in the presence of insulin. FGF-21 and insulin exert a synergistic effect on glucose metabolism through mutual sensitization.

Fibroblast growth factor-21 (FGF-21) is an important metabolism regulator, however, whether FGF-21 has effects on cardiovascular remains unclear. In this study, H2O2-induced injury in H9c2 cells was used as a cell model, the anti-apoptosis potential and mechanism of FGF-21 against oxidative injury were evaluated by MTT assay, flow cytometry assay and real-time PCR. The results showed that FGF-21 could increase the cell survival of H2O2-induced injury in H9c2 cells and prevent H9c2 cells from oxidative stress-induced apoptosis. Furthermore, FGF-21 can elevate SOD activity and regulate Bcl-2/Bax expression in H9c2 cells. The results suggest that FGF-21 have protective effect against the H2O2-induced apoptosis in H9c2 cells.

Objective: To evaluate the feasibility and efficacy of salvage surgery after local failure of definitive chemoradiotherapy (dCRT) for esophageal carcinomas., Methods: We retrospectively reviewed the esophageal cancer patients underwent salvage surgery (Group A, 26 cases) or non-surgical therapy (Group B, 11 cases) after local failure of dCRT(cT1-3N0-1M0) between July 2008 and June 2010., Results: The rate of resection was 84.6% in Group A, R0 was 69.2%. There was no mortality after surgery. The rate of postoperative complications is 53.8%, especially pneumonia 30.8%, anastomosis leakage 11.5% and arrhythmia 7.7%. The median survival time is 11.1 months; the 2-year survival rate of Group A was 23.1% in Group A. The non-surgical therapy was given including second-line chemotherapy and esophagus stents; the median survival time is 8.1 months (3.1-15.1) in Group B. The survival rate of Group A was higher than Group B (Kaplan-Meier, P = 0.013)., Conclusion: Salvage surgery provides survival benefit for esophageal cancer patients with local persistent or recurrence after primary dCRT, despite of high morbidity.Salvage surgery should be carried out for patients with good physical condition and complete resection is technically possible.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on hypertension induced by insulin resistance in rats and to provide mechanistic insights into its therapeutic effect. Male Sprague-Dawley (SD) rats were fed with high-fructose (10%) water to develop mild hypertensive models within 4 weeks, then randomized into 4 groups: model control, FGF21 0.25, 0.1 and 0.05 micromol x kg(-1) x d(-1) groups. Five age-matched normal SD rats administrated with saline were used as normal controls. The rats in each group were treated once a day for 4 weeks. Body weight was measured weekly, systolic blood pressure (SBP) was measured noninvasively using a tail-cuff method, insulin sensitivity was assessed using oral glucose tolerance test (OGTT) and HOMA-IR assay. At the end of the treatment, blood samples were collected, and blood glucose, serum cholesterol, serum triglyceride and serum insulin were measured. The results showed that blood pressure of the rats treated with different doses of FGF21 returned to normal levels [(122.2 +/- 3.5) mmHg, P < 0.01] after 4-week treatment, whereas, SBP of untreated (model control) rats maintained a high level [(142.5 +/- 4.5) mmHg] throughout the treatment. The observation of blood pressure in 24 h revealed that SBP of FGF21 treated-rats maintained at (130 +/- 4.5) mmHg vs. (143 +/- 5.5) mmHg for model control (P < 0.01). FGF21 treatment groups improved serum lipids obviously, total cholesterol (TC) and triglyceride (TG) levels decreased significantly to normal levels. The serum NO levels of three different doses FGF21 treatment group were significantly higher than that of the model control group [(7.32 +/- 0.11), (7.24 +/- 0.13), (6.94 +/- 0.08) vs. (6.56 +/- 0.19) micromol x L(-1), P < 0.01], and the degree of improvement showed obvious dose-dependent manner, indicating that FGF21 can significant increase serum NO in fructose-induced hypertension rat model and improve endothelial NO release function. The results of OGTT and HOMA-IR showed that insulin resistance state was significantly relieved in a dose-dependent manner. Thus, this study demonstrates that FGF21 significantly ameliorates blood pressure in fructose-induced hypertension model by relieving insulin resistance. This finding provides a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of essential hypertension.

Objective: To discuss the model of reasonable dissection extent of mediastinal lymph nodes in non-small cell lung cancer of diameter less than 2 cm., Method: A study was carried on the clinical data of 192 patients with NSCLC of diameter less than 2 cm undergoing curative resection and mediastinal lymph nodes dissection,According to the size of tumor and the pathology quick report., Results: The survival rates of patient was statistically significant difference (P < 0.01), prognostic factors included diameter of tumor, lymph node metastasis and visceral pleura invasion;51.7% mediastinal lymph node metastasis of superior lobe tumor, 28.8% transfering to subcarinal node; the mediastinal lymph node metastasis rate of adenocarcinoma was 32.2%, and squamous cell carcinoma was 15.4% (P = 0.0012) ., Conclusion: If the patient's cardiopulmonary function permitting, regardless of the size of focus, Regional mediastinal lymph nodal and subcarinal lymph nodal dissection should be routinely performed on patients with non-small cell lung cancer of diameter less than 2 cm, and improve survival rate.

Objective: To analyze the clinical features, precaution and management of complete heart block (CHB) after transaortic extended septal myectomy operation (extended Morrow procedure) in patients with hypertrophic obstructive cardiomyopathy (HOCM)., Methods: From October 1996 to December 2011, 10[6 men; mean age (45.4 ± 15.8) years, range 13-60 years] out of 160 consecutive HOCM patients underwent extended Morrow procedure developed CHB postoperatively. Their clinical data were retrospectively analyzed. Baseline transthoracic echocardiography showed that the left ventricular outflow tract (LVOT) gradients was from 68 to 149 (105.1 ± 25.9) mm Hg (1 mm Hg = 0.133 kPa), ECG showed right bundle branch block in 5 patients and atrial fibrillation, atrial premature beats or ST-T segment changes in other 5 patients. Besides extended Morrow procedure, concomitant surgical procedures included mitral valve replacement (MVR) in 2 (2/10) and MVR plus coronary artery bypass grafting in another 2 (2/10) patients. Follow-up data were obtained by subsequent clinic visits in outpatient department and telephone interviews., Results: The in-hospital mortality was 20% (these two patients died of low cardiac output syndrome and multiple organs failure). Four patients underwent MVR simultaneously survived the operation. Postoperative echocardiography demonstrated a reduced LVOT gradient[(13.6 ± 9.7) mm Hg, P < 0.001]. Permanent pacemakers were implanted in all 8 survived patients at 6 days to 7 months after operation. No other severe complications were observed. During follow-up [from 4 to 72 (19.4 ± 22.1) months], there was no death, 1 patient readmitted to our center at 71 months post operation to change the pacemaker because of low voltage of previously implanted pacemaker. Physical capacity and quality of life improved significantly post operation in these 8 patients. The NYHA functional class remained at I-II post operation and during follow up., Conclusions: CHB is a severe complication after extended Morrow procedure for patients with HOCM and timely permanent pacemaker implantation is mandatory for patients with post procedure CHB.

Insulin is the most common medicine used for diabetic patients, unfortunately, its effective time is short, even the long-acting insulin cannot obtain a satisfactory effect. Fibroblast growth factor (FGF)-21 is a recently discovered glucose mediator and expected to be a potential anti-diabetic drug that does not rely on insulin. In this study, db/db mice were used as the type 2 diabetic model to examine whether mFGF-21 has the long-term blood lowering effect on the animal model. The results showed that mFGF-21 could stably maintain the blood glucose at normal level for a long-term in a dose-dependent manner. Administration of mFGF-21 once a day with three doses (0.125, 0.25 and 0.5 mg x kg(-1)) could maintain blood glucose of the model animals at normal level for at least 24 h. Administration of mFGF-21 every two days with the same doses could maintain blood glucose of the model animals at normal level for at least 48 h, although it took longer time for blood glucose to reach to normal level depending on doses used (twenty injections for 0.125 mg x kg(-1) and 0.25 mg x kg(-1) doses, ten injections for 0.5 mg x kg(-1) dose). Surprisingly, the blood glucose of the treated model animals still maintained at normal level for 24 h after the experiment terminated. Glycosylated hemoglobin level of the animals treated with mFGF-21, which represented long-term glucose status, decreased significantly compared to the control group and the insulin group. The results suggest that FGF-21 has potential to become a long-acting and potent anti-diabetic drug.

Objective: To assess the clinical outcomes of transaortic extended septal myectomy on early and midterm survival of patients with hypertrophic obstructive cardiomyopathy (HOCM)., Methods: From October 2009 to April 2012, 118 consecutive patients underwent extended Morrow's procedure for HOCM. There were 69 males and 49 females with an average age of (46 ± 13) years. Their clinical data were analyzed retrospectively. Preoperative transthoracic, intraoperative transoesophageal and postoperative transthoracic echocardiography was performed to assess septal thickness, left ventricular outflow tract (LVOT) gradient, mitral valve function and systolic anterior motion (SAM) of anterior mitral valve leaflet, etc. Concomitant surgical procedures were performed if other cardiac diseases required surgical interventions. Follow-up study was carried out during subsequent clinic visits at outpatient department and through telephone interviews with patients and their relatives., Results: The septal thickness was (25 ± 7) mm. SAM was detected in all. The in-hospital mortality was 0.8% (1/118) since one patient died of multiple organs failure one week later. Postoperative echocardiography demonstrated marked reduction in LVOT gradient (92 ± 22 vs 13 ± 10 mm Hg (1 mm Hg = 0.133 kPa), P = 0.000), New York Heart Association (NYHA) class (2.9 ± 0.6 vs 1.2 ± 0.4, P = 0.000) and significant improvement in mitral regurgitation. Concomitant surgical procedures were performed in 45 cases (38.1%, all for preexisting conditions). Complications included complete atrioventricular block (n = 3), first degree atrioventricular block (n = 6), complete left bundle branch block (n = 51), intraventricular conduction delay or left anterior division block (n = 26), transient renal dysfunction (n = 2) and intra-aortic-balloon-pumping (n = 2). No other severe complication was observed. During a follow-up period of 1 - 27 (7 ± 6) months, there was no readmission or death. All patients reported significant increase in physical ability and obvious decrease in limiting symptoms. At the latest follow-up, the NYHA functional class maintained grade I-II in all. And mitral regurgitation remained absent or mild., Conclusion: Surgical procedure for HOCM patients is both safe and efficacious. It provides an excellent relief of LVOT obstruction.

Objective: To compare the efficacy and feasibility of neoadjuvant chemoradiotherapy with docetaxel plus cisplatin or with cisplatin plus fluorouracil in the treatment of local advanced esophageal squamous cell carcinoma., Methods: A total of 154 cases in the stage of cT3N0-1M0 were randomly assigned to two arms. The arm A received 2 cycles of doctaxel 75 mg/m(2) plus cisplatin 25 mg/m(2) d1-3 and 40 Gy of radiation therapy, and the arm B received 2 cycles of cisplatin 25 mg/m(2) d1-3 plus fluorouracil 600 mg/m(2) d1 ∼ 5 and 40 Gy of radiation therapy. The surgery was performed 3 - 4 weeks later., Results: Grade 3/4 toxicities occurred in 53.2% of the patients in arm A and in 36.4% of the patients in arm B (P = 0.035). Neutropenia occurred in 20.7% of the patients in arm A and 5.6% of the patients in arm B (P = 0.004). Nine patients aborted surgery due to tumor progression. 71 patients underwent resection in 73 cases of the arm A and 69 patients underwent complete resection, 70 patients underwent resection in 72 cases and 70 complete resection of the arm B, respectively (P > 0.05). No mortality was noted. The overall complication rate was similar in the two arms (21.9% vs. 23.6%). Pathological complete response was achieved in 27 patients (35.1%) in the arm A and 16 patients (20.8%) in the arm B (P = 0.048)., Conclusions: Neoadjuvant chemoradiotherapy with docetaxel plus cisplatin can be well tolerated and achieves a higher pathological complete response rate than with cisplatin plus fluorouracil.

Fibroblast growth factor 21 (FGF21) is a member of FGF family. It has been demonstrated that FGF21 is an independent, safe and effective regulator of blood glucose levels in vivo. In order to improve the activity of FGF21, we exchanged the beta10-beta12 domain of the human FGF21 with that of the mouse FGF21 to construct a novel FGF21 gene (named hmFGF21), and then subcloned hmFGF21 gene into the SUMO expression vector to create pSUMO-hmFGF21 and transformed it into E. coli Rosetta for expression of the fusion protein SUMO-hmFGF21. Both in vitro and in vivo glucose regulation activity of hmFGF21 was evaluated. The SDS-PAGE result showed that compared with wild-type hFGF21, the soluble expression of hmFGF21 increased about 2-fold. HmFGF21 was more potent in stimulation of glucose uptake in HepG2 cells in vitro. The results of anti-diabetic effect on db/db mice demonstrated that hmFGF21 had better efficacy on controlling the blood glucose of the db/db diabetic animals than wild-type hFGF21. These results suggest that the biological properties of FGF21 are significantly improved by optimization.

Objective: To explore the anti-reflux effects of esophagogastric anastomoses by reverse stapling with Nissen fundoplication (RSNF)., Methods: A total of 103 cases of lower esophageal carcinomas and esophagogastric junction carcinomas undergone reverse stapled anastomoses with Nissen fundoplication between July 2009 and December 2010 at our hospital were retrospectively reviewed. And fistula, stricture and gastroesophageal reflux were compared with those of 130 traditional cases., Results: RSNF required more time than the traditional group (16.42 vs 14.02 min, P < 0.001). No fistula was found in neither group. There were 13 complications in RSNF and 23 in the traditional group (χ(2) = 0.44, P = 0.58). The rate of stricture was 4.8% (5/103) in RSNF and 6.9% (9/130) in the traditional group (χ(2) = 0.44, P = 0.58). There were 16 reflux esophagitis (15.5%) in RSNF and 29 in the traditional group (22.3%) (χ(2) = 2.57, P = 0.46). The post-RSNF reflux symptoms were more severe than the traditional group (31.1% vs 49.2%, χ(2) = 7.825, P = 0.007, score of GerdQ>8)., Conclusion: Reverse stapling with Nissen fundoplication may be conveniently performed with definite anti-reflux effects for esophagogastric anastomoses.

Objective: To evaluate safety and feasibility of circular staplers in cervical esophagogastrostomy after esophageal cancer resection., Methods: The clinical data of patients with esophageal carcinoma were analyzed retrospectively. These patients underwent esophagectomy and cervical esophagogastrostomy with mechanical staplers from August 2009 to April 2011 in the Henan Provincial People's Hospital., Results: A total of 202 patients had the anastomosis performed successfully except for one case who had esophageal tear during anastomosis and required hand-sewn repair. There was no operative mortality. Six patients developed cervical anastomotic leakage after operation, and all were treated conservatively. There was no thoracic anastomotic leakage and other complications related to anastomosis. Two patients had obvious gastroesophageal reflux. After a median of 10.2 months of follow-up, there was no anastomotic stricture., Conclusion: Circular mechanical stapling in cervical esophagogastric anastomosis is a safe and feasible operative procedure.